Cerebral venous thrombosis

Abstract

Cerebral venous thrombosis (CVT) is a rare disease, requiring urgent diagnosis and treatment. Clinical presentation is highly variable but headache result in the most frequent presentation (90%). Diagnosis is based on magnetic resonance imaging which shows the thrombus and parenchymal lesions, completed by angiography, magnetic resonance angiography and/or CT angiography. A large spectrum of general and local causes or predisposing factors should be investigated. Treatment is based on full anticoagulation even in the hemorrhagic varieties. Prognosis is better in comparison to arterial stroke (death rate: around 5%). Some severe or even malignant cases need to be identified in order to prevent further complications like cerebral herniation leading to death. In these cases, management in the intensive care unit is indicated and decompressive craniectomy may be lifesaving, allowing a good final functional recovery.